GMS: HIV and Transport Infrastructure Risk Mitigation Initiatives

Shireen Lateef Senior Advisor (Gender), Office of Vice President KMSD
The views expressed in this paper are the views of the author and do not necessarily reflect the views or policies of the Asian Development Bank (ADB), or its Board of Governors, or the governments they represent. ADB does not guarantee the accuracy of the data included in this paper and accepts no responsibility for any consequence of their use. The countries listed in this paper do not imply any view on ADB's part as to sovereignty or independent status or necessarily conform to ADB's terminology.

HIV Prevention and Infrastructure in GMS

GMS Regional Connectivity
•1992 • Roads

•2

GMS Regional Connectivity
•2008 • Roads

•3

GMS Regional

Connectivity
•2015
• Roads

•4

Goods on the Move

HIV Prevention and Infrastructure in GMS

People on the Move

Young People Migrate for Work
Young men and women at Special Economic Zone

Young male construction workers in Cambodia

HIV and Infrastructure
Local communities Mobile Men (women, young girls) with Money (construction workers, truck HIV–Trafficking Risk drivers)

At the Cross-roads

Migrant and mobile populations (EPZ and
factory workers)

Commercial and entertainment establishments (casinos,
beer bars and female sex workers)

Connectivity – Roads and Transport Corridors

Upside - Benefits
• Easier and faster travel
• Less dust, respiratory diseases, health benefits • Access to health and education services • Service delivery – agriculture extension services • More economic activity
– More employment opportunties/jobs – Income earning opportunities
HIV Prevention and Infrastructure in GMS

Connectivity – Roads and Transport Corridors

Upside - Benefits
• Easier and faster travel
• Less dust, respiratory diseases, health benefits • Access to health and education services • Service delivery – agriculture extension services • More economic activity
– More employment opportunties/jobs – Income earning opportunities
HIV Prevention and Infrastructure in GMS

Connectivity – Roads and Transport Corridors

Upside - Benefits
• Easier and faster travel
• Less dust, respiratory diseases, health benefits • Access to health and education services • Service delivery – agriculture extension services • More economic activity
– More employment opportunties/jobs – Income earning opportunities
HIV Prevention and Infrastructure in GMS

Income Opportunities

HIV Prevention and Infrastructure in GMS

Factory Workers at
Special Economic Zone Near the Border

Connectivity – Roads and Transport Corridors

Downside and Risks
• Influx of construction workers (males)
• Other migrant and mobile populations • Mushrooming of beer bars, brothels, casinos • spread of diseases - HIV/AIDS • trafficking of women and girls • Social disruption in isolated communities
HIV Prevention and Infrastructure in GMS

Casino Development Cambodia Border Crossing Zone

Bavet

Northern Economic Corridor

Northern Economic Corridor

ADB Response Review of Experience in GMS
• February–July 2007: Case study review of HIV experience in 4 transport loan projects • Findings  HIV mitigation not coordinated with national HIV programs  limited budget allocation, contracting works  no clear roles/functions assigned for implementation  role of MOT or health, other agencies in mitigation  targeted only road construction workers  should HIV mitigation be part of construction contract, separate contract, TA or loan?  need for post-construction interventions

HIV Prevention and Infrastructure in GMS

ADB Response
• Recognize links between connectivity and the spread of HIV • Mitigate HIV risk and vulnerability heighted by transport and infrastructure development
PreConstruction Construction Phase PostConstruction

Comprehensive Response

RETA 6467 –HIV Prevention and Infrastructure: Mitigating Risk in the Greater Mekong Subregion
Road Corridors • CAM: Road Improvement (post construction) • CAM: Northwest Provincial Roads (pre-construction) • LAO: Northern Economic Corridor (post-construction) • LAO-VIE: East-West Economic Corridor (post construction) • CAM-VIE: PP-HCMC Highway (post-construction) • VIE: Second Northern GMS Transport Network (pre-construction)

Project Design Settings Approach
• HIV Prevention Package
• • • • Construction Sites Entertainment Settings Mobile Populations Local communities

• Behavior change and communication • Strengthening medical services • Provision of medical packages (commodities) • Workplace HIV Prevention Program • factories, casinos, mines • Monitoring and Evaluation
 Targets young women; sex workers; construction workers, migrant and mobile groups, truck drivers, military personnel HIV Prevention and Infrastructure in GMS

Local Community

HIV Prevention and Infrastructure in GMS

Construction Workers

HIV Prevention and Infrastructure in GMS

The END

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